成年人尿镉水平与糖尿病关系的研究

Relationship between urinary cadmium and type 2 diabetes mellitus in adults

目的探讨成年人尿镉水平及其他环境因素与糖尿病的关系。方法采用病例对照研究设计,纳入166例糖尿病病例和427例非糖尿病对照。采用结构式问卷调查研究对象的一般情况。采集研究对象外周血进行血糖及血生化指标的检测,采集尿液进行尿镉的检测,尿液指标以肌酐校正。非条件logistic回归模型分析糖尿病的影响因素,揭示其与尿镉之间的关系。结果文化程度为小学及以下(P=0.016)、女性(P=0.013)、不吸烟者(P=0.014)、不饮酒者(P=0.025)、以及BMI>25.00 kg/m^2的糖尿病者(P=0.040,P=0.025)尿镉水平高于同组的非糖尿病者;60~69岁糖尿病组的尿镉水平高于非糖尿病组(P=0.024)。多因素分析结果显示,糖尿病家族史(OR=3.19,95%CI:1.45~7.03)、文化程度(OR=1.50,95%CI:1.08~2.08)、尿镉水平(OR=1.61,95%CI:1.08~2.41)为糖尿病的影响因素。结论环境镉暴露和糖尿病有密切关系,减少镉暴露对糖尿病防控有一定意义。

Objective To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults. Methods Case-control study was adopted, including 166 cases and 427 controls. General characteristics of the subjects were collected by a structured questionnaire. FPG, biochemical indexes and urinary cadmium (UCd) were detected respectively, while UCd was corrected with creatinine. Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM. Results Levels of UCd appeared higher in cases with the following characteristics as: having primary school education (P=0.016), being female (P=0.013), being non-smokers (P=0.014) or non-alcoholic (P=0.025), and with BMI>25.00 kg/m^2 (P=0.040, P=0.025) than those appeared in the control group. Same results were shown in the 60-69 years (P=0.024) old group. Data from the unconditional logistic regression analysis showed that family history of DM (OR=3.19, 95%CI: 1.45-7.03), education status (OR=1.50,95%CI: 1.08-2.08) and UCd (OR=1.61, 95%CI: 1.08-2.41) were influencing factors on DM. Conclusion A close association between UCd and DM was noticed. UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.